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Home My WebLink AboutBuilding Permit #325 - 40 SALEM STREET 11/12/2008 BUILDING PERMIT c� NORrN q ttUeo ,s ti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION vy Permit NO: Date Received �f .0Awren 0, gSSACHUs�� Date Issued: 2 IMPORTANT: Applicant must complete all items on this page LOCATION 1 � f r►� Print, PROPERTY'OWNER M-tc_ r div ✓'� Print MAP NO: PARCEL: Ct ZONING DISTRICT: Historic District yes x Machine Strop Village -yes (bb TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well; Floodplain Wetlands Vatershed Distract Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: Kj+c_it e u .Md U., `� �.✓ ff�r , C�v�/�z/s Identification Pje3se Type or Print Clearly) OWNER: Name: M,'C_�a e ( 6aue.,^ Phone: 9"_ 2-5-9`3 7z-5'7- Address: z-5'ZAddress: CONTRACTOR dame. Phone- - Address: Su,pervlsor's`Construction License, Exp. date: Horie,lrnprovement Licenser Exp. ate; ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ -70016 FEE: $ �S y Check No.: y� Receipt No.: L,6� 7 NOTE: Persons contracting with unr gister d contractors do not have access to the guaranty fund ignatare of Agent/Owner �' ignature ofcontractor Building Department artment The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application n .. ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract j ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application 1 Doc:Building Permit Application Revised 2.2008 I Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster onsiteyes ino Located at i 24 Main Street 'Fire Depariment'signatureldate w COMMENTS- Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or.service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.s100-s10o0 fine NOTES and DATA— (For department use ❑ Notified for pickup - Date i .._._.............-..._........................._.._ ---......----....................................-......._------.....__....__.........--...._-...........................-- ---._.........._................._......._......... __...._. Doc.Building Permit Revised 2008 r 4 Location No. Date NORT►► TOWN OF NORTH ANDOVER 419 Certificate of Occupancy $ NU,t<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ ` TOTAL $ Check # 21614 . Building Inspector VkORTH omm Of Andover No. 3�s WFI 0 over, Mass., 0 COCHIC EWICK 0/"ATED C) BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......Me/.A�... .. .................................................................................................. Foundation has permission to erect........................................ buildings an .... -.s.r............................................... Rough to be occupied as....i....... CA- � i :................................................................... .. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file n Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTES ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S ARTS Rough ........................ "...................... ................... ................................ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place'on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. pORTM TOWN OF NORTH ANDOVER OFFICE OF , p BUILDING DEPARTMENT * * Osgood ood Street Building 20, Suite 2-36 g �►'*�.`..:: `� North Andover Massachusetts 01845 �s < swcwuse Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please ncLat DATE: JOB LOCATION: Number Street Address MaplLot HOMEOWNER Yihore/ ��d�.VIC `l 2�Pi- 7-z-ai Name Home Phone Work Phone PRESENT MAILING ADDRESS Ax City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,prdvided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which helshe resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. 1 The uNerag� 1>r>uNnvae certifies that he/she u>,dorctuic the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption TIOARDOF \PPFA1.S6?8-')5 1 CONS.ERV.1'RON68S-9530 1TEAL111588-9540 PLANNING 68N-9535